Archived: Autism Wessex - Manor Road

Manor Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide accommodation for persons who require personal care. It is registered for up to four people with learning disabilities and autistic spectrum disorder. At the time of our inspection there were four people living in the home.

The home was a two storey detached property which had an open plan kitchen dining area, large lounge, a sensory room and one bedroom on the ground floor. On the first floor there were three further spacious en-suite bedrooms and a staff sleep-in room.

The care service had been developed and designed in line with the values that underpinned the Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. People with learning disabilities and autism using the service could live as ordinary a life as any citizen.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. When people were at risk of seizures or behaviours which may challenge the service, staff understood the actions needed to minimise avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

Where possible people had been involved in assessments of their care needs and had their choices and wishes respected including access to healthcare when required. Their care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. People’s eating and drinking preferences were understood and their dietary needs were met. Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. People were supported to express their views about their care using their preferred method of communication and were actively supported to have control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories and the people important to them. Equality Diversity and Human Rights (EDHR) were promoted and understood by staff. A complaints process was in place, people and families felt listened to and actions were taken if they raised concerns. The registered manager had started to explore opportunities to identify and understand people’s end of life wishes and preferences.

The service had an open and positive culture within Manor Road. Leadership was visible and promoted good teamwork. Staff spoke highly about the management and had a clear understanding of their roles and responsibilities. Audits and quality assurance processes were effective in driving service improvements. The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had completed training on how to safe guard people from abuse and had their level of understanding checked. They were aware of the actions they needed to take if they suspected a person was at risk of abuse.

Staff had a good understanding of the risks people were living with and how they needed to support people to keep them safe. This included risks associated with peoples physical and mental well- being, their home environment and when they were accessing the community.

People’s risks were managed with the minimum restrictions on their freedoms and choices.

The organisation carried out a quarterly health and safety audit of the building and meetings.

There were enough staff to support people safely during the day and night and when people accessed the community. Staff had been recruited safely. The organisation had policies and procedures in place to manage unsafe practice. Staff had received an induction and on- going training which enabled them to carry out their roles effectively

Medicines had been ordered, stored, administered and disposed of safely. Staff had received training in medicine administration and had their competencies regularly checked by a senior member of staff. People had good access to healthcare services.

The service was working within the principles of the Mental Capacity Act. We saw that best interest decisions had been taken for people and had included input from staff, families and social workers. Staff had completed training and had a good understanding of the legislation and how to put it into practice when supporting people.

Staff had a good understanding of people’s dietary needs and any associated risks. Meal choices were varied and nutritional.

Families and health professionals we spoke with described the service as caring. Staff were described as patient and always having people’s interests at heart. Staff who had a good knowledge of people living at the service and the best way to communicate with each person. People and their families were involved in decisions about care.

Staff respected people’s right to privacy. We observed interactions between staff and people that were respectful and maintained a persons’ dignity. Some people needed staff to observe them most of the time. Staff achieved this in the least restrictive way respecting people’s rights to having freedom and independence around their home.

People had individual support plans that focused on providing support in a way that ensured opportunities to make choices and maximise levels of independence whilst remaining safe. Support plans included details of activities people enjoyed both in groups and individually. People had health action plans and communication plans that had been developed to support people when accessing services in the community. Support plans had been reviewed a minimum of monthly and families told us they felt involved in their relatives care.

The service user guide contained information about how to make a complaint and was also available in easy read format.

Families, staff and health and social care professionals all told us the service was well led and that the registered manager was approachable. The registered manager had set up service development meetings which had been attended by staff, families and trustees. The meetings had been used to gather views on the service and led to new initiatives that had improved service quality.

Staff spoke positively about the service, the management and the team work. The service used the expertise of other recognised professional organisations to support practice development and continually improve the quality of service people received.

Audits were completed that effectively gathered information about the service and where appropriate had led to positive change.

We also observed the support people received, examined records, and spoke with the manager and four other staff.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity make decisions, the provider acted in accordance with legal requirements.

People experienced care and support that met their needs and protected their rights.

There were appropriate arrangements in place to protect people against the risks associated with medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had an effective system to monitor the quality of the service and to identify and manage risks to people's health, safety and welfare. A support worker told us their manager was supportive and promoted good practice effectively .

People had personalised plans of care and support, while lacking capacity people were supported in decisions about their care and support. We saw records that showed plans were followed on a daily basis, and that interventions were informed by up to date guidance and best practice. There was clear guidance to support staff dealing with emergency situations.

People told us they felt safe at the home. Staff had been trained in safeguarding and had a good understanding of adult protection issues related to the needs of service users.

Good relations were observed between staff and residents. Staff said they felt well supported and valued by the organisation running the service.

There were sound arrangements in place to monitor and assess the quality and safety of the service. There were a range of methods to engage service users, families and other stakeholders in the running of the home. There was a complaint procedure and staff and management were supportive toward complainants.